[Right atrial rupture caused by closed chest injury]

A case of right atrial laceration secondary to closed chest trauma is reported. Thirteen cases treated surgically with success have previously been reported. Rupture of a cardiac chamber represents 64 p. 100 of cardiac events after closed chest trauma; the right atrium is involved in 61 p. 100 of atrial lesions, either at the auricle or at the veno-atrial junction. The diagnosis is often difficult due to the gravity of associated lesions but it should be suspected systematically. In the absence of a pericardial laceration tamponade may develop; when associated wih pericardial rupture, a recurrent hemothorax may be observed. The emergency surgery should be performed through a median sternotomy or an anterior thoracotomy. Although repair may be possible on the beating heart, cardiopulmonary bypass is extremely useful for repair and exploration of the coronary vessels in the atrioventricular groove. The prognosis depends on the rapidity of patient transport and the speed of diagnosis.